Michigan Laws 500.3402a – Group disability insurance policy; provisions required
Current as of: 2023 | Check for updates
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Terms Used In Michigan Laws 500.3402a
- Contract: A legal written agreement that becomes binding when signed.
- Disability insurance policy: includes an insurance policy or insurance contract that insures against loss resulting from sickness or from bodily injury or death by accident, or both, including also the granting of specific hospital benefits and medical, surgical, and sick-care benefits to an individual, family, or group, subject to the exclusions provided in this section. See Michigan Laws 500.3400
- Fraud: Intentional deception resulting in injury to another.
- insured: as used in this chapter , shall not be construed as preventing a person other than the insured with a proper insurable interest from making application for and owning a policy covering the insured or from being entitled under such a policy to any indemnities, benefits and rights provided therein. See Michigan Laws 500.3462
- Insurer: means an individual, corporation, association, partnership, reciprocal exchange, inter-insurer, Lloyds organization, fraternal benefit society, or other legal entity, engaged or attempting to engage in the business of making insurance or surety contracts. See Michigan Laws 500.106
- Trustee: A person or institution holding and administering property in trust.
An insurer shall include all of the following provisions in a group disability insurance policy:
(a) That the policy, application of the employer or of an executive officer or trustee of an association, and the individual applications, if any, of the employees or members insured, constitute the entire contract between the parties. The insurer’s identification of what constitutes the entire contract creates a rebuttable presumption that the identified items are the entire contract.
(b) That a statement made by the employer, the executive officer or trustee of an association, or an individual employee or member, in the absence of fraud, is a representation and not a warranty. An insurer shall not use a statement made by the employer, the executive officer or trustee of an association, or an individual employee or member as a defense to a claim under the policy, unless the statement is contained in a written application.
(c) That the insurer will issue to the employer or the executive officer or trustee of an association, for delivery to an employee or member who is insured under the policy, an individual certificate that states the insurance protection to which the employee or member is entitled and to whom benefits are payable.
(d) That new employees or members, as applicable, who are eligible and who apply will be added to the group or class originally insured.